卡维地洛对心脏缺血再灌注心律失常发生率的影响  

Reduction of incidence of ischemia-reperfusion induced ventricular arrhythemia by carvedilol

作　　者：曾玉杰[1] 冯义柏[1] 于世龙[1] 黄战军[1] 杨海玉[2] 苗立夫 

机构地区：[1]华中科技大学同济医学院心血管病研究所华中科技大学同济医学院附属协和医院心内科,武汉430022 [2]广东省江门市中心医院心内科 [3]协和医科大学协和医院心内科

出　　处：《临床心血管病杂志》2001年第11期520-523,共4页Journal of Clinical Cardiology

摘　　要：目的 :评价第三代肾上腺素 β受体拮抗剂———卡维地洛 (Carvedilol,CVD)对大鼠在体心脏缺血再灌注心律失常发生率的影响。方法 :通过左前降支冠状动脉结扎 ,建立大鼠在体心脏缺血再灌注损伤模型。术前 7d连续胃管给CVD(1mg/kg) ,结扎左前降支冠状动脉 30min后松开进行再灌注 36 0min ,处死动物。观察室性心律失常和肌酸激酶 同工酶、乳酸脱氢酶、一氧化氮及丙二醛变化 ,并进行苏木精 伊红染色及电镜检查。结果 :CVD使再灌注期间室性心律失常发生率减少 5 3.85 % (P <0 .0 1) ,死亡率减少 5 7.15 % (P <0 .0 1)。CVD减少肌酸激酶 同工酶、低密度脂蛋白及丙二醛的释放 ,稳定一氧化氮的分泌。心肌苏木精 伊红染色及电镜检查对照组细胞明显呈片状或局灶性坏死 ,闰盘结构紊乱 ,大量反应性的中性粒细胞浸润于坏死细胞之间。CVD组心肌细胞损伤程度明显减轻 ,闰盘结构基本完整 ,粒细胞浸润也明显减少。结论 :CVD明显降低心脏缺血再灌注心律失常的发生率和死亡率 。Objective:The aim was to evaluate the antiarrhythmia effects provided by a new β adrenceptor antagonist carvedilol (CVD) in a rat model of acute myocardial ischemic reperfusion injury.Method:Myocardial infarction (MI) was induced by the ligation of left anterior descending coronary artery (LAD) for 30 min, followed by rperfusion of 360 min in rats. Rats were treated with CVD (1 mg/kg) for 7 days before MI. The ventricular arrhythmia were observed and LDH, CK MB, NO, MDA were measured. The tissue samples removed from infracted areas were examined by light microscopy after staining with hematoxylin and eosin (HE) and electron microscope. Result:CVD reduced the morbidity and mortality of rats with ventricular arrhythmia by 53.85 % and 57.15 % (P< 0.01 ). In CVD treated rats, the levels of LDH, CK MB and MDA were decreased but the level of NO was stable (P> 0.05 ). In control group, HE stained wax sections and thin section electron microscope showed conspicuous extensive and focal necrosis of myocytes, disorganized intercalated disks, a large of neutrophil infiltration in ischemic areas. In CVD treated groupe, the damage degree of myocytes and intercalated disks,neutrophil infiltration were evidently reduced. Conclusion:CVD reduces incidence of cardiac arrhythmia, provides a powerful cardioprotective effect in ischemic reperfusion myocardium.

关 键 词：心律失常 心肌再灌注 卡维地洛 发病率 

分 类 号：R541.7[医药卫生—心血管疾病]